Provider Demographics
NPI:1497894315
Name:HORSLEY, STEPHEN BRENT (MD , FACS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:BRENT
Last Name:HORSLEY
Suffix:
Gender:M
Credentials:MD , FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10300 W CHARLESTON BLVD
Mailing Address - Street 2:13 180
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-1037
Mailing Address - Country:US
Mailing Address - Phone:702-796-0022
Mailing Address - Fax:702-796-0038
Practice Address - Street 1:9280W SUNSET RD 242
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-4861
Practice Address - Country:US
Practice Address - Phone:702-796-0022
Practice Address - Fax:702-796-0038
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242418208600000X
AZ71758208600000X
NV12245208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery